Zhou LL, Zhu SG, Fang Y, Huang SS, Huang JF, Hu ZD, Chen JY, Zhang X, Wang JY. Neck pain and absence of cranial nerve symptom are clues of cervical myelopathy mimicking stroke: Two case reports. World J Clin Cases 2022; 10(32): 11835-11844 [PMID: 36405285 DOI: 10.12998/wjcc.v10.i32.11835]
Corresponding Author of This Article
Jian-Yong Wang, MD, PhD, Doctor, Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, B305-B307 Biomedicine Research Building, Wenzhou 325027, Zhejiang Province, China. wangjianyong2020@126.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Zhou LL, Zhu SG, Fang Y, Huang SS, Huang JF, Hu ZD, Chen JY, Zhang X, Wang JY. Neck pain and absence of cranial nerve symptom are clues of cervical myelopathy mimicking stroke: Two case reports. World J Clin Cases 2022; 10(32): 11835-11844 [PMID: 36405285 DOI: 10.12998/wjcc.v10.i32.11835]
Li-Li Zhou, Shi-Guo Zhu, Yuan Fang, Shi-Shi Huang, Jie-Fan Huang, Ze-Di Hu, Jin-Yu Chen, Xiong Zhang, Jian-Yong Wang, Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
Author contributions: Zhou LL, Zhu SG, and Wang JY examined the patient and carried out the treatment strategy; Wang JY, Zhou LL, Fang Y, Huang SS, Huang JF, Hu ZD, and Chen JY acquired and analyzed all the clinical data; Wang JY, Zhou LL, and Zhu SG reviewed the literature and drafted the manuscript; Wang JY and Zhang X supervised the study; all authors read, revised, and approved the final version of the manuscript.
Supported bythe Wenzhou Municipal Science and Technology Bureau, No. Y2020065; Education Foundation of Zhejiang, No. Y202044311; and Fundamental Research Funds for Wenzhou Medical University, No. KYYW202030.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Jian-Yong Wang, MD, PhD, Doctor, Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, B305-B307 Biomedicine Research Building, Wenzhou 325027, Zhejiang Province, China. wangjianyong2020@126.com
Received: April 13, 2022 Peer-review started: April 13, 2022 First decision: June 16, 2022 Revised: June 27, 2022 Accepted: August 24, 2022 Article in press: August 24, 2022 Published online: November 16, 2022 Processing time: 209 Days and 0.2 Hours
Abstract
BACKGROUND
Cervical myelopathy is a potential stroke imitator, for which intravenous thrombolysis would be catastrophic.
CASE SUMMARY
We herein present two cases of cervical myelopathy. The first patient presented with acute onset of right hemiparesis and urinary incontinence, and the second patient presented with sudden-onset right leg monoplegia. The initial diagnoses for both of them were ischemic stroke. However, both of them lacked cranial nerve symptom and suffered neck pain at the beginning of onset. Their cervical spinal cord lesions were finally confirmed by cervical computed tomography. A literature review showed that neck pain and absence of cranial nerve symptom are clues of cervical myelopathy.
CONCLUSION
The current report and the review remind us to pay more attention to these two clues in suspected stroke patients, especially those within the thrombolytic time window.
Core Tip: Cervical myelopathy is a potential stroke imitator, for which intravenous thrombolysis would be catastrophic. Herein we present two cases of stroke mimics whose final diagnoses were spontaneous spinal epidural hematoma and cervical spine metastases, respectively. From our case report and the literature review, we suggested that neck pain and absence of cranial nerve symptom are clues of cervical myelopathy. More attention should be paid to the two features in patients with suspected stroke.
